Currently, there are 4 levels of coverage in Health Insurance – Bronze, Silver, Gold and Platinum. Bronze has the lowest premium and has the highest co-pays and deductible while Platinum is the most expensive and has the lowest co-pays and deductible. In fact, Gold and Platinum have NO deductible – and that’s very enticing to a lot a people who find it annoying that they never seem to meet their deductible during the year, so they end up paying for everything out-of-pocket. I often hear people say “I pay for health insurance but I never get anything.”
Consequently, many people consider a Gold or Platinum plan because they don’t want a deductible. But here’s a little secret… while the Silver Plan has a deductible, that deductible is waived unless you are admitted to a hospital or have surgery. In other words, the Silver plan has no deductible (unless you are admitted to a hospital or have surgery). And if you think about it, how often does that happen?
Granted, the Gold and Platinum plans also have lower co-pays than the Silver plan. But let’s see how much additional monthly premium you’re paying for those lower co-pays. As of this writing, here are rates for a husband and wife (both 35) with a 10 year old child:
- $ 871/mo Silver PPO
- $1,081/mo Gold PPO
- $1,383/mo Platinum PPO
So here’s the question: Is it worth $210 – $512 per month to lower your co-pays by $10 or $20? Even if you were hospitalized and had to pay the Silver Plan’s $2500 deductible, you would have paid $2,520 extra in premium for the Gold plan or $6,144 extra in premium for the Platinum Plan. Therefore, it might make more sense to buy the Silver plan and pay the deductible only IF you’re hospitalized rather that paying the extra premium every single year whether you’re hospitalized or not.
Having said all that, everybody should make their own decision. There may be situations where a Gold or Platinum plan makes sense for you – even if it simply buys you peace of mind.
Author: neil steinman
Neil Steinman is the principal of Orange County Health & Life Insurance in Orange County, CA. Neil prides himself in keeping things simple and easy for his clients while providing them with the best products from the top carriers. In addition to working directly with clients, Neil is also an instructor of Health Insurance and Medicare to licensed insurance agents. Neil has been in the industry for nearly 20 years.